Provider Demographics
NPI:1649655028
Name:DHARAIYA, DEVANSHI
Entity type:Individual
Prefix:
First Name:DEVANSHI
Middle Name:
Last Name:DHARAIYA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4801 GLENWOOD AVE STE200
Mailing Address - Street 2:PMB-1110
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27612-3857
Mailing Address - Country:US
Mailing Address - Phone:216-370-8105
Mailing Address - Fax:877-794-5929
Practice Address - Street 1:400 MATTHEW ST STE 211
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:OH
Practice Address - Zip Code:45750-1656
Practice Address - Country:US
Practice Address - Phone:740-568-4150
Practice Address - Fax:740-568-4151
Is Sole Proprietor?:No
Enumeration Date:2015-07-27
Last Update Date:2022-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA01012680932084N0400X
NC2019-013282084N0400X
MI43011077022084N0400X
OH35.1463522084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology